Gastrointestinal symptoms in 609 Japanese patients with COVID-19: a single-center retrospective study

Abstract

Background

GI symptoms are common in acute COVID-19 patients. This study aimed to characterize the GI symptoms occurring in Japanese COVID-19 patients.

Methods

This retrospective single-center cohort study included 751 hospitalized acute COVID-19 patients. The primary outcomes were the frequency and severity of GI symptoms. The secondary outcomes included the association between COVID-19 severity and GI symptoms and the timing of GI symptom onset.

Results

After exclusion, the data of 609 patients were analyzed. The median age was 62 years, and 55% were male. The median time from initial symptom onset to admission was five days. On admission, 92% of the patients had fever, 35.1% had fatigue, 75% had respiratory symptoms, and 75% had pneumonia. The sample included patients with mild (19%), moderate (59%), and severe COVID-19 (22%). A total of 218 patients (36%) had GI symptoms, of which 93% were classified as grade 1/2; 170 patients had both respiratory and GI symptoms. Diarrhea was the most frequent GI symptom, occurring in 170 patients, followed by anorexia in 73 patients and nausea/vomiting in 36 patients, and abdominal pain in 8 patients. There was no significant relationship between COVID-19 severity and GI symptoms. Among COVID-19 patients with both GI and respiratory symptoms, 48% had respiratory symptoms preceding GI symptoms, 25% had GI symptoms preceding respiratory symptoms and 27% had a simultaneous onset of respiratory and GI symptoms.

Conclusion

Thirty-six percent of the Japanese COVID-19 patients had GI symptoms; diarrhea was the most frequent GI symptom but did not predict severe COVID-19.

Keywords:

• Gastrointestinal symptom
• COVID-19
• diarrhea
• nausea
• vomiting
• abdominal pain

Acknowledgment

The authos thank all medical staff members and doctors at Toyonaka Municipal Hospital, including Dr. Saeko Nakatsubo and Dr. Megumi Osaki in the division of respiratory disease, Department of Internal Medicine.

Ethical approval

Opt-out informed consent protocol was used for this study. This consent procedure was reviewed and approved by the Institutional Review Board of Toyonaka Municipal Hospital approval number [No. 2022-03-05].

Patient consent statement

The requirement for informed consent was waived using the opt-out method on our hospital website.

Author contributions

Conceptualization; analysis and interpretation of data; and drafting of the manuscript: Kuriki S and Nishida T; acquisition of data: Kuriki S, Nishida T, Chang L, Hosokawa K, Fuji Y, Osug N, Nakamatsu D, Matsumoto K, Yamamoto M, Morimura O, Abe K, Okauchi Y, Iwahashi H, Inada M; critical revision of the manuscript: Morimura O, Okauchi Y, Iwahashi H; review & editing, Nishida T. All authors listed have contributed substantially to the design, data collection and analysis, and editing of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available on request from the corresponding author Nishida T. The data are not publicly available due to restrictions, e.g., they contain information that could compromise the privacy of the research participants.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.